Title: A Clinical Prospective, Randomized Study to Compare Combined Spinal Epidural Bupivacaine – Fentanyl and Ropivacaine – Fentanyl for Lower Abdominal and Pelvic Surgeries
Authors: Dr Kulvendra Yadav, Shikha Goyal
Aim: We conducted this prospective, randomized, double blind study with an aim of comparing the effect of Combined Spinal Epidural Bupivacine with fentanyl and Ropivacaine with Fentanyl for post-operative analgesia in lower abdominal and pelvic surgeries.
Methodology: Eighty patients or lower abdominal & pelvic surgeries were studied after randomization into 2 groups with 40 patients in each group. Group BF– patients received 3 ml bupivacaine 0.5% for subarachnoid block and epidural top up 0.125% bupivacaine plus Fentanyl 25 mg diluted and made up to 8cc with Normal saline Group RF – Patients received 3ml ropivacaine 0.75% for subarachnoid block and epidural top up 0.125% ropivacaine plus Fentanyl 25 mg diluted and made up to 8cc with NS.
The parameters observed included haemodynamic data, pain score by visual analogue scale scale, duration of surgery, Requirement of first dose of rescue analgesia. Side effects like nausea, vomiting shivering, hypotension and bradycardia were observed and managed symptomatically. times of recording were before administration of first epidural top up, 5,10 15,30 min after drug given,1,2,3,4,6,8,10& 12 hr after drug administration.
Results: Haemodynamioc data and Pain score of patients of both groups were comparable at all time periods (p>0.05). Times for first dose of rescue analgesia and duration of surgery were comparable in both groups. No significant difference was found in both groups in respect to side effects (p>0.05).
Conclusion: We concluded that bupivacaine with fentanyl was eqully efficaceous to ropivacine with fentanyl in combined spinal epidural block for post-operative analgesics in lower abdominal and pelvic surgeries.
Keywords: Bupivacaine; Ropivacaine; Fentanyl, combined spinal epidural anaesthesia.